A state senate committee in Georgia voted Thursday to approve a bill that would ban many health insurance plans from covering abortion care except in a narrowly defined “medical emergency.”
The bill, SB 98, would make Georgia the 25th state to ban insurance coverage of abortion on the health exchanges established under the Affordable Care Act. (That number includes Michigan, where such a ban has passed but has not yet gone into effect.) It would also prevent Georgia’s more than 600,000 state employees from accessing insurance coverage for abortion. More than 100,000 Georgians are already enrolled in health insurance coverage under the Affordable Care Act.
Georgia state employees are already forbidden from accessing insurance coverage of abortion care, but the ban is an administrative one that the state health board pushed through last year after a similar bill failed to gain enough votes to pass the legislature. SB 98 would codify that ban into law, and would only marginally expand the exceptions. Currently, state employees can only receive coverage for life-saving abortions; the new law would allow either state employees or women purchasing insurance on the exchanges to get coverage if an abortion prevents the “substantial and irreversible impairment of a major bodily function.”
“It’s a health exception so narrow that it’s practically nonexistent,” Amanda Allen, state legislative counsel at the Center for Reproductive Rights, told RH Reality Check. The exception, Allen said, only covers immediate threats to a woman’s health, not complications from health conditions. A woman would not be covered, and face prohibitive costs, if she needed an abortion to start chemotherapy, to avoid exacerbating a heart condition, or to protect her mental health.
This narrow definition of “medical emergency” was also used in Georgia’s 20-week abortion ban, which is currently blocked by courts, and shows up frequently in so-called health exceptions to other restrictive abortion laws around the country.
Bans on insurance coverage of abortion, reproductive rights advocates say, are a common anti-choice strategy to undermine abortion access in a piecemeal fashion.
“We know that state politicians want abortion to be illegal, and they aren’t always able to do it outright,” Gretchen Borchelt, director of state reproductive health-care policy at the National Women’s Law Center, told RH Reality Check. “So what they are doing is pushing restrictions that make abortion more unaffordable, or interfere with a woman’s ability to get access to abortion.” Borchelt noted that banning abortion coverage on the exchanges is also one of many attempts to undermine the Affordable Care Act.
Abortion insurance bans gained national attention late last year when Michigan passed a law that opponents called “rape insurance,” because it bans all insurance coverage of abortions, including in cases of rape or incest, unless a woman purchases an additional insurance rider. Allen called the proposed Georgia insurance ban “slightly less extreme” than Michigan’s; Michigan’s is one of the most extreme laws in the nation. The Georgia ban would not affect all private insurers, but like Michigan’s it would provide no exceptions for rape or incest (it would not provide an option to purchase additional coverage for such cases). Unlike Michigan’s, the Georgia bill would provide at least a marginal health exception.
CORRECTION: A previous version of this article incorrectly noted that Michigan’s abortion insurance coverage ban would not affect all private insurers; it would. We regret the error.